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    Prevention Guidelines

    Prevention Guidelines for Women 40–49

    Here are the screening tests and immunizations that most women ages 40 to 49 need. This plan does not include recommendations for pregnancy. Although you and your healthcare provider may decide that a different schedule is best for you, this plan can guide your discussion.

    Screening

    Who needs it

    How often

    Type 2 diabetes or prediabetes

    All adults beginning at age 45 and adults with no symptoms at any age who are overweight or obese and have 1 or more additional risk factors for diabetes

    At least every 3 years

    Alcohol misuse

    All adults

    At routine exams

    Blood pressure

    All adults

    Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommends the following screening schedules:

    • Every 2 years if your blood pressure reading is less than 120/80 mm Hg, or

    • Yearly if systolic blood pressure reading of 120 to 139 mm Hg or diastolic blood pressure reading of 80 to 89 mm Hg

    Breast cancer

    All women*

    Screening with a mammogram every year is an option starting at age 40. At age 45 start yearly mammograms.*

    Cervical cancer

    All women, except those who had a hysterectomy (with removal of the cervix) for reasons not related to cervical cancer and no history of cervical cancer or serious precancer

    Women between the ages of 30 and 65 should have a Pap test plus an HPV test (called "co-testing") every 5 years. This is the preferred approach, but it is also acceptable to continue to have Pap tests alone every 3 years.

    Chlamydia

    Women at increased risk for infection

    At routine exams if at risk

    Depression

    All adults in clinical practices that have staff and systems in place to assure accurate diagnosis, effective treatment, and follow-up

    At routine exams

    Gonorrhea

    Sexually active women at increased risk for infection

    At routine exams if at risk

    Hepatitis C

    Anyone at increased risk; 1 time for those born between 1945 and 1965

    At routine exams if at risk

    HIV

    All women

    At routine exams

    Lipid disorders

    All women age 45 and older at increased risk for coronary artery disease

    For women ages 19 to 44, screening should be based on risk factors1; discuss with your healthcare provider

    At least every 5 years

    Obesity

    All adults

    At routine checkups

    Syphilis

    Women at increased risk for infection

    At routine exams if at risk

    Tuberculosis

    Anyone at increased risk for infection

    Check with your healthcare provider

    Vision

    All adults2

    Baseline comprehensive exam at age 40; if you have a chronic disease, check with your healthcare provider for exam frequency

    Counseling

    Who needs it

    How often

    Breast cancer, chemoprevention

    Women at high risk

    When risk is identified

    BRCA mutation testing for breast and ovarian cancer susceptibility

    Women with increased risk

    When risk is identified

    Diet and exercise

    Adults who care overweight or obese

    When diagnosed and at routine exams

    Domestic violence

    Women of child-bearing age

    At routine exams

    Sexually transmitted disease prevention

    Anyone at increased risk for infection

    At routine exams

    Tobacco use and tobacco-related disease

    All adults

    Every exam

    Immunization

    Who needs it

    How often

    Tetanus/diphtheria/pertussis (Td/Tdap) booster

    All adults

    Td: every 10 years

    Tdap: substitute a one-time dose of Tdap for a Td booster after age 18, then boost with Td every 10 years

    Chickenpox (varicella)

    All adults in this age group who have no record of previous infection or vaccinations

    2 doses; the second dose should be given at least 4 weeks after the first dose

    Measles, mumps, rubella (MMR)

    All adults in this age group who have no record of previous infection or vaccinations

    1 or 2 doses

    Flu vaccine (seasonal)

    All adults

    Yearly, when the vaccine becomes available in the community

    Hepatitis A vaccine

    People at risk3

    2 doses given 6 months apart

    Hepatitis B vaccine

    People at risk4

    3 doses; the second dose should be given 1 month after the first dose; the third dose should be given at least 2 months after the second dose (and at least 4 months after the first dose)

    Haemophilus influenzae type B (HIB)

    People at risk

    1 to 3 doses

    Meningococcal

    People at risk**

    1 or 2 doses

    Pneumococcal conjugate vaccine (PCV13) and pneumococcal polysaccharide vaccine (PPSV23)

    People at risk5

    1 or 2 doses

    * American Cancer Society

    **Exceptions may exist, please discuss with your healthcare provider

    1Recommendation from the American Congress of Obstetricians and Gynecologists

    2Recommendation from the American Academy of Ophthalmology

    3For complete list, see the CDC website

    4For complete list, see the CDC website

    5For complete list, see the CDC website

    Immunization schedule from the CDC

    Online Medical Reviewer: Stump-Sutliff, Kim, RN, MSN, AOCNS
    Online Medical Reviewer: Cunningham, Louise, RN
    Online Medical Reviewer: Godsey, Cynthia, MSN, APRN, MSHE, FNP-BC
    Online Medical Reviewer: Turley, Ray, BSN, MSN
    Date Last Reviewed: 11/5/2015
    © 2000-2017 The StayWell Company, LLC. 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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    Southern New Mexico
    Surgery Center

    2301 Indian Wells Rd. Suite B
    Alamogordo, NM 88310
    www.snmsc.org

    Phone: 575.437.0890
    Fax: 575.437.0905
    Email: info@snmsc.org

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